title: Double-balloon enteroscopy in small bowel tumors: a Chinese single-center study.
abstract: OBJECTIVE
  To analyze the clinical characteristics of small bowel tumors detected by double-balloon enteroscopy (DBE) and to evaluate the diagnostic value of DBE in tumors.
  
  
  METHODS
  Four hundred and forty consecutive DBE examinations were performed in 400 patients (250 males and 150 females, mean age 46.9 ± 16.3 years, range 14-86 years) between January 2007 and April 2012. Of these, 252 patients underwent the antegrade approach, and 188 patients underwent the retrograde approach. All the patients enrolled in our study were suspected of having small bowel diseases with a negative etiological diagnosis following other routine examinations, such as upper and lower gastrointestinal endoscopy and radiography tests. Data on tumors, such as clinical information, endoscopic findings and operation results, were retrospectively collected.
  
  
  RESULTS
  Small bowel tumors were diagnosed in 78 patients, of whom 67 were diagnosed using DBE, resulting in a diagnostic yield of 16.8% (67/400); the other 11 patients had negative DBE findings and were diagnosed through surgery or capsule endoscopy. Adenocarcinoma (29.5%, 23/78), gastrointestinal stromal tumor (24.4%, 19/78) and lymphoma (15.4%, 12/78) were the most common tumors. Among the 78 tumors, 60.3% (47/78) were located in the jejunum, and the overall number of malignant tumors was 74.4% (58/78). DBE examinations were frequently performed in patients with obscure gastrointestinal bleeding (47.4%) and abdominal pain (24.4%). The positive detection rate for DBE in the 78 patients with small bowel tumors was 85.9% (67/78), which was higher than that of a computed tomography scan (72.9%, 51/70). Based on the operation results, the accuracy rates of DBE for locating small bowel neoplasms, such as adenocarcinoma, gastrointestinal stromal tumor and lymphoma, were 94.4%, 100% and 100%, respectively. The positive biopsy rates for adenocarcinoma and lymphoma were 71.4% and 60%, respectively.
  
  
  CONCLUSIONS
  DBE is a useful diagnostic tool with high clinical practice value and should be considered the gold standard for the investigation of small bowel tumors.
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Wen-Guo
authors.initials: WG
authors.lastname: Chen
authors.forename: Guo-Dong
authors.initials: GD
authors.lastname: Shan
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: Min
authors.initials: M
authors.lastname: Yue
authors.forename: Zun
authors.initials: Z
authors.lastname: Xiang
authors.forename: Ying
authors.initials: Y
authors.lastname: Cheng
authors.forename: Chen-Jiao
authors.initials: CJ
authors.lastname: Wu
authors.forename: Ying
authors.initials: Y
authors.lastname: Fang
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Chen
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D053704:Capsule Endoscopy; D016009:Chi-Square Distribution; D002681:China; D058582:Double-Balloon Enteroscopy; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007414:Intestinal Neoplasms / Q000473:pathology* / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D008223:Lymphoma / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Capsule endoscopy; Diagnosis; Double-balloon enteroscopy; Endoscopic findings; Small bowel tumors